The efficacy and safety of modified DCF regimen and XELOX regimen in elderly patients with advanced gastric cancer

YIN Hong-yan; SHI Yan; WU Zhi-yong; HAN Quan-li; DAI Guang-hai

Abstract：Objective:To investigate the efifcacy and adverse drug reaction of modiifed DCF (mDCF) regimen and XELOX regimen as ifrst-line chemotherapy in elderly patients with advanced gastric cancer. Methods:From January 2010 to December 2013, 60 patients diagnosed with metastases and treated with ifrst-line chemotherapy of mDCF or XELOX regimen in our hospital were analyzed retrospectively. The ages of the patients were all greater than 65, mDCF group contained 22 cases, while XELOX group included 38 cases. The clinical data of these 60 patients were collected. The objective response rates (ORR), disease control rates (DCR), progression-free survival (PFS) and overall survival (OS) were compared between the two groups. Results:The short-term effect of mDCF regimen was better than that of XELOX regimen, and either PFS or OS was longer than XELOX group. There was statistically signiifcant difference in PFS between the two groups (14.2 vs 5.8 months, P=0.002), but the difference of OS was not statistically signiifcant (20.8 vs 12.0 months, P=0.107). Multivariate Cox analysis showed that chemotherapy was a independent prognostic indicator of PFS (HR 2.461; 95%CI 1.308 – 4.628; P = 0.005), but no significant association was found between chemotherapy and OS (P=0.747). The incidence of nausea, vomit and leukopenia were higher in mDCF regimen group than that of XELOX group, while the incidence of peripheral neurotoxicity and hand-foot syndrome was lower in mDCF group. But the toxicities were rarely in grade Ⅲ–Ⅳ. Conclusion: In elderly patients, both mDCF regimen and XELOX regimen have similar overall survival time, and toxicities are all tolerated. However, mDCF regimen has better short-term efifcacy and prolonged progression-free survival time.